Topical Area: Community and Public Health Nutrition, Obesity
Objectives : An 18-month, two-arm, randomized, controlled trial designed to evaluate the comparative impact of two home visiting programs on gestational weight gain, postpartum weight loss, and diet was conducted with rural, Southern, African American women. Although nutrition education was an experimental treatment component, the intervention was not effective at improving participants’ poor diets. To better understand the dietary choices made by these women, an examination of the food environment was conducted in the towns in which they resided.
Methods : Food retailers were measured with the Nutritional Environment Measures Surveys (NEMS). ArcGIS was used to geocode study participants’ residence and food retailers and to compute driving distances between participants’ residence and food retailers. Participants’ diet quality was measured with Healthy Eating Index (HEI). Associations among food retailers’ type and NEMS score, driving distances between residences and food retailers, and HEI total and component scores were examined.
Results : Significant differences between types of food retailers were found for percent of maximum NEMS scores: grocery stores (60%), full service restaurants (42%), fast food restaurants (36%), and convenience stores (26%). Participants were closer to convenience stores (mean = .4 miles) and fast food restaurants (mean = .5 miles) than to full service restaurants (mean = 1.1 miles) and grocery stores (mean = 1.6 miles). Three-fourths of participants lived within ½ mile of a convenience store and two-thirds lived within ½ mile of a fast food restaurant, while 6% lived within ½ mile of a grocery store. Only 19% shopped at their closest grocery store while two-thirds traveled a greater distance to shop at a larger national chain grocery store. The mean distance to the closest grocery store was 1.6 miles as compared to 4.2 miles for the store where most of the food was purchased. The refined grains HEI score was negatively correlated with distances to the closest convenience store, fast food restaurant, and full service restaurant.
The food environment of these rural, Southern, African American women provided numerous, convenient opportunities for unhealthy eating.
Funding Sources : US Department of Agriculture, Agricultural Research Service.